Outline

Objective: To report postoperative functional outcomes for vestibular schwannomas (VS) in a large series.

Methods: Over a period of 10 years, 594 patients with VS were dignosed in our department. Among them, 461 patients underwent surgery via translabyrinthine, retrosigmoid, middle fossa and transchecholear approaches.

Results: Translabyrinthine(72.9%), retrosigmoid (13.7%), middle fossa (10.4%) and transchecholear (3.0%) approaches were performed in 461 cases (77.6%), which was selected by tumor size, location, hearing estimation, and patients’ age. Total, near total and patial removal rate was 95.9%, 3.0% and 1.1%, respectively. Hearing preservative approaches were attempted in 111 cases, among which 25.2% and 48.6% have good and useful hearing. Facial nerve was anatomically preserved in 435 cases (99.4%) and interrupted in 26 cases with above large tumors and/or recurrent tumors.1 patients (0.2%) died of cerebrovascular accident. Lower cranial nerve dysfunction occurred in 13 patients. CSF leakage occurred in 15 cases (3.3%). Recurrent rate was 2.2%.

Conclusions: Correct estimation of tumor in nature is of great importance in the determination of proper treatment strategy or surgical approaches. Although microsurgery is still the most available method, the ratio of “wait & scan” and SRT is increasing. The preoperative management, surgical skills, and experience play a pivotal role in complete tumor resection.Postoperative complications can be prevented and be cured by careful surgical procedures and postoperative management. Total tumor removal and VII & VIII preservation could reach a high ratio in hands of experienced surgeon.